医院感染的表皮葡萄球菌对大环内酯-林可酰胺-链阳菌素B耐药性分析  

Prevalence of Resistance to Macrolide,Lincosamide and Streptogramin B Antibiotics in Staphylococcus epidermidis Caused Nosocomial Infection

作　　者：贾宁[1] 徐志凯[1] 沈玉杰[2] 白立彦[3] 

机构地区：[1]第四军医大学,陕西西安710032 [2]吉林大学中日联谊医院,吉林长春130033 [3]解放军总医院,北京100853

出　　处：《中华医院感染学杂志》2006年第8期935-937,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助(30300296)

摘　　要：目的了解引发医院感染的表皮葡萄球菌对大环内酯-林可酰胺-链阳菌素B(MLSB)抗菌药物的耐药情况,指导临床用药。方法收集了引发医院感染的表皮葡萄球菌126株,检测红霉素、克林霉素、克拉霉素、阿奇霉素、头孢西丁和喹奴普汀/达福普汀的最小抑菌浓度(MIC);并用D试验检测细菌诱导型和MS耐药表型。结果126株表皮葡萄球菌中,90株为耐甲氧西林表皮葡萄球菌(MRSE),36株为甲氧西林敏感菌株(MSSE);对红霉素、克林霉素、克拉霉素和阿奇霉素的耐药率分别为92.8%、73.8%、89.7%和91.3%;MRSE中红霉素和克林霉素的耐药率分别为96.7%和85.6%;MSSE中分别为83.3%和80.6%;结构型(cMLSB)、诱导型(iMLSB)和泵出型MLSB(MS)耐药菌株分别为93株(73.8%),13株(10.3%),11株(8.7%);在cMLS中,MRSE占的比例较高78.5%,而在iMLS中MSSE较多(P<0.05);所有菌株对喹奴普汀/达福普汀均敏感(MIC≤1mg/L)。结论在所收集的菌株中MLSB的耐药率较高,以结构型耐药为主,需谨慎使用MLSB类抗菌药物。OBJECTIVE To determine the prevalence of antibiotic resistance to macrolide, lincosamide and streptograminB （MLSB） in Staphylococcus epidermidis caused nosocomial infections and give guide for clinical antibiotics usage. METHODS Totally 126 S. epidermidis isolates were collected to test the minimal inhibitory concentrations （MIC） of erythromycin, clindamycin, clarithromycin, and azithromycin, quinupristin/dalfopristin and cefoxitin. Inducible type of MLSB resistance （iMLSB） and MS phenotypes were distinguished by double disk diffusion method （D test） as detailed by the NCCLS. RESULTS Among 126 S. epidermidis isolates, 90 （71.4%） isolates were meticillin resistant （MRSE）, 36 （28. 6%） were meticillin susceptive （MSSE）. The rates of antibiotic-resistance to erythromycin, clindamycin, clarithromycin, axithromycin were 92.8%, 73.8%, 89.7% and 91.3 %, respectively. Percentages of strains resistant to erythromycin and clindamycin were 96.7% and 85.6 %in MRSE, and 83.3%and 80. 6%in MSSE. Constitutive phenotype, inducible phenotype and MS phenotype were detected in 93 （73.8 % ）, 13 （ 10. 3% ）, and 11 （8. 7% ） isolates, respectively. In constitutive phenotype, the MRSE proportion appeared high（78.5 % ）, in contrast, in inducible phenotype, MSSE proportion appeared high （75%）. No resistance to quinupristin/dalfopristin was detected in all isolates （MIC≤ ling/L）,. CONCLUSIONS The prevalence of antibiotic resistance to MLSB is high in the collected isolates. The main antibiotic phenotype is constitutive phenotype. MLSB antibiotics should be used judiciously.

关 键 词：表皮葡萄球菌 大环内酯-林可酰胺-链阳菌素B 

分 类 号：R378.1[医药卫生—病原生物学]